Disease Description (Causes and Symptoms)
- Definition: A plastic surgery procedure (liposuction, body contouring) that selectively removes subcutaneous fat excessively accumulated in localized areas to improve body shape. It is not surgery intended for weight loss; its purpose is to improve the contours of localized areas.
- Causes/Pathophysiology: Fat cells become excessively accumulated in specific areas depending on sex, genetics, eating habits, and lifestyle. Liposuction removes the fat cells themselves and therefore reduces the number of fat cells in the treated area, making long-term changes in body shape possible; however, overall weight control is not the primary purpose of the surgery.
- Main Symptoms (Indications): Localized fat that does not respond well to exercise or dieting (lower abdomen, thighs, buttocks, upper arms, calves, etc.), and dissatisfaction with appearance caused by protrusion or imbalance in specific areas.
Treatment Methods
- Treatment Goals: Reduction of localized fat volume and improvement of body balance.
- Procedure/Surgical Methods:
- Small areas may be treated under local anesthesia, while larger areas or multiple areas may be treated under general anesthesia.
- Representative techniques:
- Traditional liposuction (open/suction-assisted liposuction)
- Ultrasound-assisted liposuction (liquefies fat before suction)
- Syringe-assisted liposuction (for delicate areas)
- Various adjunctive technologies, including power-assisted and laser-assisted techniques, are used.
- Additional body contouring: May be performed together with skin excision (abdominoplasty), breast reduction/correction, muscle reduction procedures (e.g., calf muscle reduction or an alternative to Botox), etc.
- Safety and Scope:
- The amount of fat that can be removed at one time is limited depending on the procedure and the patient's condition. As one example of some recommendations, a range of approximately 6–7 L (6000–7000 mL) is sometimes mentioned for ultrasound-assisted liposuction. Removing large amounts is safer when performed over multiple sessions.
- Examination/Evaluation: Before the procedure, a plastic surgery examination is performed to assess the areas and amount of fat, along with a review of medical history (including heart disease, thrombosis, and bleeding disorders); blood tests, electrocardiography, and other tests may be performed if necessary.
- Precautions (During and After the Procedure):
- Because of the risk of deep vein thrombosis (DVT) and pulmonary embolism, it is essential to check for a history of thrombosis, heart disease, coagulation disorders, and other relevant conditions.
- The risk of complications increases as the amount of fat removed increases.
- Scarring, uneven or irregular skin contours, sensory changes, bleeding, infection, hematoma, and skin necrosis may occur.
- Nonpharmacological Management: Maintain weight through diet and exercise, wear compression garments (generally recommended for 3–6 months), and refrain from smoking.
Checklist Before an Outpatient Visit (Including Items to Bring and Sample Questions)
- Items/Materials to Bring:
- List of current medications (including anticoagulants, antiplatelet agents, and supplements)
- Records of previous surgeries and hospitalizations, and any history of thrombosis, heart disease, or allergies
- Recent blood test, electrocardiogram, and other test results, if available
- Weight and height, records of weight changes, and records of dieting and exercise attempts
- Photos of the areas where treatment is desired (to share goals with the doctor)
- Information to Provide the Doctor During the Outpatient Visit:
- When the symptoms began and how they have changed (changes in the area and whether pain is present)
- The specific areas where liposuction is desired and the expected results
- Personal or family history related to thrombosis, heart disease, or bleeding
- Sample Questions (Items to Ask During the Consultation):
- Is this procedure suitable for my body shape?
- What is the expected amount of fat removal, and what is the maximum safe amount that can be removed at one time?
- What preparations are needed before and after surgery, and how long is the recovery period?
Sample General Questions to Ask the Doctor
- What are the goals and limitations of this procedure? (What degree of change can be expected?)
- How should I stop any medications before surgery (e.g., aspirin or anticoagulants)?
- What type of anesthesia will be used (local/general), and what are the risks related to anesthesia?
- How will pain be managed after surgery, and what is the recovery schedule (return to daily activities and exercise)?
- How should complications be managed if they occur, and is repeat surgery possible?
- How permanent are the results? What happens if I gain weight?
Sample Condition-Specific Questions
- I have a history of deep vein thrombosis or heart disease. Can I safely undergo liposuction? Will additional tests or preventive measures (e.g., anticoagulation management) be needed?
- I need to have a large amount of fat removed at once. If dividing the procedure into multiple sessions is recommended, what should the interval between each procedure be, and what is the overall treatment plan?
Emergency symptoms (immediate hospital visit recommended): sudden severe pain or excessive bleeding at the procedure site, difficulty breathing, chest pain, or sudden swelling or pain in a leg (suspected thrombosis), etc.